A new study links childhood depression to later health risk. What families should watch out for, and what can be done.

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Depression is typically diagnosed in adults, but children also struggle with the condition. New research now indicates those depressed children are more likely to be obese, smoke and not engage in physical activity — all risk factors for heart problems — when they become adolescents.

The new study from researchers at Washington University School of Medicine in St. Louis and the University of Pittsburgh revealed that of those depressed in childhood, 22 percent were already obese by age 16, and a third of them smoked cigarettes daily.

This is especially troubling since adolescents who have cardiac risk factors are “much more likely to develop heart disease as adults and even to have a shorter lifespan,” according to the study’s first author Robert M. Carney, PhD, a professor of psychiatry at Washington University.

So, in spite of the fact that most of the children studied were later treated successfully for their depression, the impact of the disease is likely to be felt later in life.

Nowadays, roughly 2 percent of children between 6 and 12 years of age have depression. Remarkably, it can be diagnosed in children as young as 2 or 3. Yet, even today, depression is probably underdiagnosed in children — and a diagnosis of depression in childhood was practically unheard of before the 1980s.

Such was the case for Therese J. Borchard, whose depression during childhood went largely unnoticed. Author and blogger Borchard, 42, said she experienced suicidal thoughts beginning in the fourth grade.

“With my parents there was just no understanding,” she said. “I think it’s really important to understand that [depression] can affect children.”

Part of the problem is that signs of depression in children may be mistaken for bad behavior, growing pains or a “phase” that they’ll outgrow.

Just as in adults, everyday stresses, such as preparing for a test or peer pressure, can trigger normal behavioral changes in a child. And, “sadness is a normal emotion that each person, including children, can experience especially when they’re feeling frustrated,” said Ben Vitiello, MD, the chair of the Child and Adolescent Treatment and Preventive Intervention Research Branch within the National Institute of Mental Health.

But there’s a big difference between a child that’s just being moody or difficult, and one that is really suffering from depression, which is an illness and often requires treatment.

Signs of Depression

According to Vitiello, the two most important signs of depression to look for in a child are sadness that lasts most of the day and an irritable, angry mood. These signs are often accompanied by an inability to enjoy things that used to be fun, difficulty sleeping, changes in appetite and feeling tired all the time for no medical reason.

In children, particularly between the ages of 9 and 12, behavior regression — acting younger than their age by whining or throwing temper tantrums — is often an indication of depression.

Certainly, a family history of depression increases the risk, even in young children, so parents should factor it in when evaluating possible signs of illness in their child. “Even though I have an aunt who took her life, it still wasn’t enough to really alert the adults in my life that it was a substantial problem,” said Borchard, who didn’t start receiving treatment for her depression until she was 18.

Keep in mind that emotions within any family dynamic — positive or negative — can be contagious. Depression can be very disruptive, and impacts not just the one suffering but the entire family, including other children.

As with any illness, realizing something may be wrong with your child is heartbreaking. But if you suspect your child might be depressed, don’t ignore it. Get a doctor involved.

Treating the Illness

The first step in treating the depression is to understand what could be causing it. Your family doctor may suggest therapy with a psychiatrist or psychologist.

“Medication is an option,” said Vitiello, but “it's not really a magic bullet.” It doesn't work for everyone, and some children even respond negatively to medications with more feelings of anxiety.

Family support is key. A depressed child can feel isolated, even when they’re not alone. Real family time combined with a constant positive, nurturing environment can be as critical to a child’s treatment as any medication or therapy.

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